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In their research on adolescent pregnancy, the World Health Organization (WHO) shared that complications during pregnancy and childbirth are the second largest cause of death among 15 to 19-year-old girls. The WHO also estimates that 3 million girls aged 15 to 19 undergo unsafe abortions yearly. As a result, it's imperative that sexual and reproductive health services are inclusive of the needs of adolescents and young women.
However, in many cases, adolescents and young women seeking safe abortion services face different barriers to adult women. According to IPPF, young people face a number of compounded barriers when seeking safe abortion services:
- Capacity: Young people can be judged as incapable of making their own informed decisions, leading to young people being denied abortion services, or requiring parental or spousal consent
- Compounded stigma: Many young people women are expected to not have sex until they are older and/or married, so face compounded stigma when seeking sexual and reproductive health services as adolescents
- Law: In several settings, laws and policies related to abortion can be more restricted for young people, for example, requiring parental consent
- Lack of access to quality healthcare: Young people face specific barriers and quality healthcare services can be inaccessible and inappropriate to these needs, for example, if clinics are only open during inaccessible hours
- Lack of information: Often young people do not have access to accurate information on what abortion involves, their local abortion laws, or where to access youth-friendly services.
With this in mind, Ipas developed an abortion values clarification and attitude transformation (VCAT) toolkit to support providers in delivering tailored services for adolescents and young women: Abortion attitude transformation: Values clarification activities adapted for young women.
With the specific challenges facing young women in mind, the VCAT exercises provide a platform to address the following issues, among others:
- Acceptability of young women’s sexuality;
- Social stigma related to sexual activity among young unmarried women;
- Relationship between acceptability of pregnancy, age and marital status;
- Chronological age versus emotional sexual maturity;
- A young woman’s right to choose abortion versus requirement for consent;
- Issues of autonomy versus protection (how legislation ostensibly designed to protect young women may do just the opposite).
The toolkit supplements Ipas’s Abortion care for young women: A training toolkit, including six values clarification and attitude transformation activities to focus specifically on young women and safe abortion.